NICE offers advice on fractures drug

NICE issued advice last week on the fracture prevention treatment denosumab, the diabetes drug liraglutide and the cardiovascular treatment clopidogrel.

The institute backed denosumab (Prolia) for some postmenopausal women at increased risk of osteoporotic fractures if other NHS treatments are unsuitable.

NICE has also issued final guidance approving the use of the drug liraglutide for some diabetes patients. PCTs must now fund the drug for eligible patients whose clinicians wish to prescribe it.

The treatment can be given to patients with a BMI over 35 if other treatments have failed, or those with a BMI under 35 if they are not suitable for insulin. The institute has also backed wider use of clopidogrel and dipyridamole for preventing occlusive vascular events.

In guidance now out for consultation, clopidogrel can be offered to patients who have had ischaemic stroke, peripheral arterial disease or multivascular disease. But it is only recommended for MI if aspirin is unsuitable.

Modified-release dipyridamole plus aspirin may be considered for patients who have had a TIA, NICE says.

For stroke patients, this should be recommended only when clopidogrel is not tolerated or contraindicated. It should be offered alone only when treatment with clopidogrel and aspirin are unsuitable in this patient group.

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